scholarly journals Moderate- to high intensity aerobic and resistance exercise reduces peripheral blood regulatory cell populations in older adults with rheumatoid arthritis

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Sofia E. M. Andersson ◽  
Elvira Lange ◽  
Daniel Kucharski ◽  
Sara Svedlund ◽  
Karin Önnheim ◽  
...  

Abstract Objective Exercise can improve immune health and is beneficial for physical function in patients with rheumatoid arthritis (RA), but the immunological mechanisms are largely unknown. We evaluated the effect of moderate- to high intensity exercise with person-centred guidance on cells of the immune system, with focus on regulatory cell populations, in older adults with RA. Methods Older adults (≥65 years) with RA were randomized to either 20-weeks of moderate – to high intensity aerobic and resistance exercise (n = 24) or to an active control group performing home-based exercise of light intensity (n = 25). Aerobic capacity, muscle strength, DAS28 and CRP were evaluated. Blood samples were collected at baseline and after 20 weeks. The frequency of immune cells defined as adaptive regulatory populations, CD4 + Foxp3 + CD25 + CD127- T regulatory cells (Tregs) and CD19 + CD24hiCD38hi B regulatory cells (Bregs) as well as HLA-DR−/lowCD33 + CD11b + myeloid derived suppressor cells (MDSCs), were assessed using flow cytometry. Results After 20 weeks of moderate- to high intensity exercise, aerobic capacity and muscle strength were significantly improved but there were no significant changes in Disease Activity Score 28 (DAS28) or CRP. The frequency of Tregs and Bregs decreased significantly in the intervention group, but not in the active control group. The exercise intervention had no effect on MDSCs. The reduction in regulatory T cells in the intervention group was most pronounced in the female patients. Conclusion Moderate- to high intensity exercise in older adults with RA led to a decreased proportion of Tregs and Bregs, but that was not associated with increased disease activity or increased inflammation. Trial registration Improved Ability to Cope With Everyday Life Through a Person-centered Training Program in Elderly Patients With Rheumatoid Arthritis - PEP-walk Study, NCT02397798. Registered at ClinicalTrials.gov March 19, 2015.

2019 ◽  
Vol 39 (9) ◽  
pp. 1585-1594 ◽  
Author(s):  
Daniel Kucharski ◽  
Elvira Lange ◽  
Alastair B. Ross ◽  
Sara Svedlund ◽  
Caroline Feldthusen ◽  
...  

Author(s):  
Shuen Yee Lee ◽  
Alycia Goh ◽  
Ken Tan ◽  
Pei Ling Choo ◽  
Peck Hoon Ong ◽  
...  

Abstract Background Resistance training with pneumatic machines attenuates the age-associated loss in muscle strength and function in older adults. However, effectiveness of scaled-up pneumatic machine resistance training in the community is not known. We evaluated the effectiveness of a multi-site community-delivered 12-week pneumatic machine resistance programme (Gym Tonic (GT)) on muscle strength and physical function in older adults. Methods Three hundred eighteen community-dwelling older adults aged ≥65 years were randomized into 12-week (twice/week) coach-supervised-community-based-GT-programme(n = 168) and wait-list control groups(n = 150). After 12 weeks, the intervention group continued with GT-training and the control group received supervised-GT-programme for further 12 weeks (partial-crossover-design). Fried frailty score, lower-extremity muscle strength and physical function (i.e., fast and habitual gait-speed, balance, repeated-chair-sit-to-stand, short physical performance battery (SPPB)) were determined at baseline, 12 and 24 weeks. Analysis adopted a modified-intention-to-treat-approach. Results After 12 weeks, lower-extremity muscle strength improved by 11–26%(all p < 0.05) and fast gait-speed improved by 7%(p = 0.008) in GT-intervention group(n = 132) than controls(n = 118), regardless of frailty status. Other physical function performance did not differ between control and intervention groups after 12 weeks (all p > 0.05). Frailty score improved by 0.5 in the intervention but not control group(p = 0.004). Within the intervention group, lower-extremity muscle strength and physical function outcomes improved at 24 weeks compared with baseline (all p < 0.001). Within controls, lower-extremity muscle strength, SPPB, repeated-chair-sit-to-stand and fast gait-speed improved post-GT (24-week) compared to both pre-GT (12-week) and baseline. Programme adherence was high in intervention [0–12-weeks,90%(SD,13%); 12–24-weeks,89%(SD,17%)] and control [12–24-weeks,90%(SD,19%)] groups. Conclusion Community-delivered GT resistance training programme with pneumatic machines has high adherence, improves muscle strength and fast gait-speed, and can be effectively implemented at scale for older adults. Future studies could examine if including other multi-modal function-specific training to complement GT can achieve better physical/functional performance in power, balance and endurance tasks. Trial registration ClinicalTrials.gov, NCT04661618, Registered 10 December 2020 - Retrospectively registered.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sylvia Sunde ◽  
Karin Hesseberg ◽  
Dawn A. Skelton ◽  
Anette Hylen Ranhoff ◽  
Are Hugo Pripp ◽  
...  

Abstract Background Many older people suffer from mobility limitations and reduced health-related quality of life (HRQOL) after discharge from hospital. A consensus regarding the most effective exercise-program to optimize physical function and HRQOL after discharge is lacking. This study investigates the effects of a group-based multicomponent high intensity exercise program on physical function and HRQOL in older adults with or at risk of mobility disability after discharge from hospital. Methods This single blinded parallel group randomised controlled trial recruited eighty-nine home dwelling older people (65–89 years) while inpatient at medical wards at a general hospital in Oslo, Norway. Baseline testing was conducted median 49 (25 percentile, 75 percentile) (26, 116) days after discharge, before randomisation to an intervention group or a control group. The intervention group performed a group-based exercise program led by a physiotherapist twice a week for 4 months. Both groups were instructed in a home-based exercise program and were encouraged to exercise according to World Health Organisation’s recommendations for physical activity in older people. The primary outcome, physical performance, was measured by the Short Physical Performance Battery (SPPB). Secondary outcomes were 6-min walk test (6MWT), Berg Balance Scale (BBS), grip strength, Body Mass Index (BMI), and HRQOL (the Short-Form 36 Health Survey (SF-36)). Data were analysed according to the intention-to-treat principle. Between-group differences were assessed using independent samples t-test. Results The groups were comparable at baseline. Intention-to-treat analysis showed that the intervention group improved their functional capacity (6MWT) and the physical component summary of SF-36 significantly compared to the control group. No further between group differences in change from baseline to 4 months follow-up were found. Conclusions A high intensity multicomponent exercise program significantly improved functional capacity and physical HRQOL in older adults with or at risk of mobility disability after discharge from hospital. The study suggests that this population can benefit from systematic group exercise after hospital-initial rehabilitation has ended. Trial registration ClinicalTrials.gov. NCT02905383. September 19, 2016.


Author(s):  
Tzu-Cheng Yu ◽  
Che-Hsien Chiang ◽  
Pei-Tzu Wu ◽  
Wen-Lan Wu ◽  
I-Hua Chu

Using exergaming for exercise training was found to improve physical fitness. Yet, few studies have used the “Xbox Kinect” to examine its effects on physical fitness in healthy middle-aged and older adults. The purpose of this study was to investigate the effect of 10-weeks of Xbox Kinect training on physical fitness in healthy middle-aged and older adults. Forty participants (average 64.00 ± 4.44 years old, eight males and 32 females) were randomized to either intervention (n = 20) or control group (n = 20). The intervention group played Xbox Kinect three times per week, for an average of 50 min per session for 10 weeks. The control group was instructed to maintain their levels of physical activity. All the participants completed assessments of body composition, muscle strength, flexibility, balance and cardiopulmonary endurance at baseline and after 10-week intervention. After 10 weeks of training, the intervention group showed significant improvements in cardiopulmonary endurance and leg muscle strength. Moreover, there were significant differences between the intervention and control group in changes in aerobic fitness and leg muscle strength. The exergame program effectively improved cardiopulmonary endurance and leg muscle strength in healthy middle-aged and older adults. It could be an alternative to conventional exercise.


Author(s):  
Weiyun Chen ◽  
Zhanjia Zhang ◽  
Bruno Giordani ◽  
Janet Larson

Background: To increase psychological well-being and physical activity (PA) behaviors, our pilot study used the social ecological model as the framework to design the 4Active intervention, focusing on multicomponent exercise group lessons at the interpersonal level and self exercise enhanced by activity trackers at the individual level. The purpose of this pilot study was to examine the effectiveness of the two-level 4Active intervention in improving psychological well-being and PA participation in older adults living in retirement communities. Methods: Participants were 27 older adults with a mean age of 85.9 ± 9.3 years. Based on the two-arm, quasi-experimental study design, fourteen older adults (2 men, 12 women) living in one retirement community (RC) were assigned into the intervention group receiving the two-level 4Active intervention, whereas 13 older adults (1 man, 12 women) living in another RC were allocated to the active control group receiving group exercise intervention alone for eight weeks. One week before and after the interventions, the participants were pre-tested and post-tested in psychological well-being (i.e., life satisfaction, subjective happiness, positive affect, and negative affect) and weekly PA minutes (i.e., weekly walking, vigorous, moderate, and total PA minutes). The data were analyzed be means of descriptive statistics, independent sample t-tests, and ANCOVA repeated measures. Results: The results of ANCOVA repeated measures indicated that both groups maintained their slightly high or very high levels of life satisfaction, happiness, and positive affect over times. However, the two-level 4Active intervention group showed significant decreases in negative affect (F = 4.78, p = 0.04, η2 = 0.23) and significance increases in weekly moderate PA (F = 10.355, p = 0.004, η2 = 0.310) compared with the active control group over time. Conclusion: It is concluded that engaging in the two-level 4Active intervention including group-based multicomponent exercises and technology-enhanced self-exercises is more effective in decreasing negative affect and increasing weekly moderate PA METS-min in physically and cognitively frail older adults over time, compared with attending the group exercises alone.


2018 ◽  
Vol 2 (3) ◽  
pp. 57
Author(s):  
Mohamat Iskandar

Background: Non-hemorrhagic stroke patients experience hemiparesis, an improper handling results in joint contractures. Discharge planning combined with a range of motion (ROM) training given to patients and their families are expected to improve muscle strength in patients after returning from the hospital. Aims: This study is to identify the effectiveness of discharge planning in increasing muscle strength. Methods: This is a quasi-experimental study with a pre-posttest design. A total of 34 respondents were selected by cluster random sampling technique, from RAA Soewondo Pati General Hospital of Pati, Central Java, Indonesia. The respondents were divided equally into two groups; an intervention group (N = 17) was given a discharge planning program together with stroke information and range of motion (ROM) training while the control group (N = 17) received a standard discharge planning available in the hospital. Further, Muscle Rating Scale (MRS) was employed to assess the muscle strength on the 2nd, 7th, and 14th day after discharge planning presented to the nonhemorrhagic stroke patients. Results: This present study clearly acknowledges the standard discharge planning program available in the hospital improve the muscle strength of the upper and lower extremity in the nonhemorrhagic stroke patients just 2nd day after the care (pretest), and the significant improvement was observed until the day 14. Moreover, combining the care with ROM training at the intervention group faster the recovery and the muscle strength improved significantly at the 7th day and continue increase at the day 14. Looking to the muscle strength since the 2nd day to the day 14, respectively the muscle strength of upper and lower limb at the control group improved at the point of 0.588 and 0.882, while at the group received the ROM training reached the value of 1.472 and 1.412. Conclusions: The ROM training combined to the current discharge planning program will faster the muscle strength recovery of the nonhemorrhagic stroke patients. This research provide insight how family plays important role to the success in monitoring the rehabilitation and recovery progress. 


2020 ◽  
Vol 16 ◽  
Author(s):  
Rahil Taheri ◽  
Shahram Molavynejad ◽  
Parvin Abedi ◽  
Elham Rajaei ◽  
Mohammad Hosein Haghighizadeh

Aim: The aim of this study was to investigate the effect of dietary education on cardiovascular risk factors in patients with rheumatoid arthritis. Method: In this randomized clinical trial, 112 patients with rheumatoid arthritis were randomly assigned into two groups, intervention and control. Dietary education was provided for the intervention group in 4 sessions; anthropometric measurements, serum levels of RF, triglycerides, cholesterol, HDL, LDL, and fasting blood sugar were measured before and three months after intervention. Data was analyzed using SPSS software and appropriate statistical tests. Results: The mean of total cholesterol (p <0.001), triglycerides (p = 0.004), LDL (p <0.001), systolic blood pressure (p = 0.001), diastolic blood pressure (p = 0.003), FBS and BMI (p <0.001) were decreased significantly in the intervention group after education compared the control group. Conclusion: Traditional care for rheumatoid arthritis patients is not enough. Patients need more education in order to improve their situation.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaoxing Lai ◽  
Lin Bo ◽  
Hongwei Zhu ◽  
Baoyu Chen ◽  
Zhao Wu ◽  
...  

Abstract Background Few studies examined interventions in frail elderly in China, while the awareness of applying interventions to prevent frailty in pre-frail elderly is still lacking. This study aimed to explore the effects of lower limb resistance exercise in pre-frail elderly in China. Methods This was a randomized controlled trial of patients with pre-frailty. The control group received routine care, while the exercise group received a 12-week lower limb resistance exercise based on routine care. The muscle strength in the lower limbs, physical fitness, and energy metabolism of the patients was evaluated at admission and after 12 weeks of intervention. Results A total of 60 pre-frail elderly were included in this study. The patients were divided into the exercise group (n = 30) and control group (n = 30) by random grouping. There were 17 men and 13 women aged 65.3 ± 13.4 in the exercise group, and 15 men and 15 women aged 67.6 ± 11.9 years in the control groups. The Barthel index was 80.3 ± 10.6 and 85.1 ± 11.6, respectively. The characteristics of the two groups were not significantly different before intervention (all p > 0.05). The results of repeated measurement ANOVA showed that there was statistically significant in crossover effect of group * time (all p < 0.05), that is, the differences of quadriceps femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, 8-ft “up & go” test, daily activity energy expenditure and metabolic equivalent between the intervention group and the control group changed with time, and the variation ranges were different. The main effects of time were statistically significant (all p < 0.05), namely, femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, 8-ft “up & go” test, daily activity energy expenditure and metabolic equivalent of the intervention group and the control group were significantly different before and after intervention. The main effects of groups were statistically significant (p < 0.05), namely, femoris muscle strength, 6-min walking test, 30-s sit-to-stand test, daily activity energy expenditure and metabolic equivalent before and after intervention were significantly different between the intervention group and the control group, while there was no significant differences in 8-ft “up & go” test between groups. Conclusion Lower limb resistance exercise used for the frailty intervention could improve muscle strength, physical fitness, and metabolism in pre-frail elderly. Trial registration ChiCTR, ChiCTR2000031099. Registered 22 March 2020, http://www.chictr.org.cn/edit.aspx?pid=51221&htm=4


Author(s):  
Niklas Sörlén ◽  
Andreas Hult ◽  
Peter Nordström ◽  
Anna Nordström ◽  
Jonas Johansson

Abstract Background We aimed to determine the effectiveness of 4 weeks of balance exercise compared with no intervention on objectively measured postural sway. Methods This was a single-center parallel randomized controlled, open label, trial. A six-sided dice was used for allocation at a 1:1-ratio between exercise and control. The trial was performed at a university hospital clinic in Sweden and recruited community-dwelling older adults with documented postural instability. The intervention consisted of progressively challenging balance exercise three times per week, during 4 weeks, with follow-up at week five. Main outcome measures were objective postural sway length during eyes open and eyes closed conditions. Results Sixty-five participants aged 70 years (balance exercise n = 32; no intervention n = 33) were randomized. 14 participants were excluded from analysis because of early dropout before follow-up at week five, leaving 51 (n = 22; n = 29) participants for analysis. No significant differences were detected between the groups in any of the postural sway outcomes. Within-group analyses showed significant improvements in hand grip strength for the intervention group, while Timed Up & Go improvements were comparable between groups but only statistically significant in the control group. Conclusions Performing balance exercise over a four-week intervention period did not acutely improve postural sway in balance-deficient older adults. The lower limit in duration and frequency to achieve positive effects remains unclear. Trial registration Clinical trials NCT03227666, July 24, 2017, retrospectively registered.


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